Dr. Jenny Gandhi

702, 7th Floor, Solaris Kode, Near Khatu Shyam Temple, VIP Road, Vesu , Surat.
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May-thurner Syndrome

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May-thurner Syndrome

+91 90033 03373

May-thurner Syndrome

Home

May-thurner Syndrome

WHAT IS
MAY-THURNER SYNDROME?

This condition, which manifests as swelling, pain, and occasionally skin changes, increases the risk of DVT in the left leg when the right iliac artery compresses the left iliac vein. Stenting the compressed vein to restore flow may be part of the treatment.

causes

Anatomical variation
Gender and age
Prolonged sitting or standing
Pregnancy and postpartum period
Medical history
Other factors

symptoms

Pain, tenderness, or throbbing in the left leg
Swelling and a feeling of heaviness or fullness in the leg
Skin discoloration
Visible varicose veins or enlarged veins
Chronic leg pain that worsens throughout the day
Left leg tightness, sometimes improving with rest and elevation
Skin changes including thickening, eczema-like rashes
Pelvic pain (related pelvic congestion syndrome), especially in women
worsening leg swelling, redness, warmth, and pain

if untreated?

Deep vein thrombosis (DVT) developed in the left leg as a result of impaired blood flow and persistent venous compression.
A pulmonary embolism (PE) is a potentially fatal blockage that happens when a blood clot from the leg breaks loose and moves to the lungs.
Blood buildup in the veins, known as chronic venous insufficiency, results in chronic leg swelling, pain, skin changes, and non-healing venous ulcers.
Persistent skin discoloration, swelling, and leg pain that severely lowers quality of life.
Higher chance of blood clots happening again and potential consequences like heart attacks or strokes if the clots spread to other organs.

diagnosis

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Doppler Ultrasonography
  • This is frequently the first non-invasive test to measure venous reflux, identify thrombosis, and gauge blood flow in the iliac veins. However, because of its deep pelvic location and surrounding structures, it might have trouble seeing the iliac vein.
Computed Tomography Venography (CTV)
  • Offers fine-grained cross-sectional pictures that demonstrate the presence of collaterals, thrombus, and other pelvic anomalies as well as the compression of the left iliac vein by the right iliac artery. It can diagnose MTS with high sensitivity and specificity.
Magnetic Resonance Venography (MRV)
  • A radiation-free substitute for CTV that is particularly helpful during pregnancy. Venous compression, collateral veins, and the distinction between thrombus and flow artifacts can all be seen with MRV.
Conventional Catheter Venography
  • The gold standard for diagnosis is conventional catheter venography, also known as digital subtraction venography, or DSV. In order to view the iliac veins and detect stenosis or occlusion, a catheter-based contrast injection is used. Additionally, it is capable of measuring pressure gradients throughout the constricted area.
Intravascular Ultrasound (IVUS)
  • Often utilized in venography or intervention, IVUS helps with precise stent placement, detects intraluminal spurs and webs, and provides real-time, high-resolution images of the vein lumen and wall.
Physical examination and clinical history
  • If there are no other explanations for the swelling and pain in the left leg, it may raise suspicion and lead to imaging tests.

Interventional Radiology
treatment

Thrombolysis

To quickly dissolve the blood clot obstructing blood flow to the brain, a drug typically alteplase or tenecteplase, is injected via a vein. Thrombolysis can greatly enhance recovery and lessen long-term disability, but it works best when administered within 4.5 hours of the onset of symptoms.
Mechanical Thrombectomy

A minimally invasive technique in which the clot is physically removed by inserting a catheter into the blocked brain artery. In certain patients, it can be done up to 24 hours after the stroke began and is particularly helpful for large vessel blockages.A minimally invasive technique in which the clot is physically removed by inserting a catheter into the blocked brain artery. In certain patients, it can be done up to 24 hours after the stroke began and is particularly helpful for large vessel blockages.
Balloon-assisted Angioplasty

A balloon is inflated inside the vessel to dilate the narrowed segment, or a stent is inserted to maintain the blood vessel open and restore normal blood flow. It is a procedure primarily used for AV fistulas linked to arterial or venous stenosis. This may occasionally be included in the treatment plan for complex AV fistulas, though it is more typical for other vascular conditions.
Stenting

When angioplasty alone causes significant residual narrowing, vessel recoil, or flow-limiting dissection, a metal scaffold (typically nitinol) mounted on a delivery catheter is positioned across the treated lesion and expanded (by balloon or self-expansion) to hold the artery open. Stents instantly provide mechanical support to maintain vessel patency.

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